Ativan (lorazepam) is a benzodiazepine used to treat anxiety disorders, insomnia, and other conditions and symptoms. It is important to take Ativan exactly as prescribed, as adverse effects and overdose can occur. Doses may vary depending on the individual, the condition being treated, and responses to the medication.
- Ativan (lorazepam) is a benzodiazepine used to treat various conditions, including anxiety disorders and insomnia.
- A typical daily dose of Ativan is between 1 and 10 mg, often taken in divided doses.
- Dosage changes should not be initiated without professional advice and monitoring, as adverse effects can occur.
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Ativan (lorazepam) forms, strengths, and administration
Ativan is a brand-name medication containing lorazepam, a benzodiazepine. Ativan, as a brand, is available as an oral tablet and as a liquid solution for injection, which should only be administered by a medical professional. Ativan tablets are available in 0.5 mg, 1 mg, and 2 mg strengths.[1][2]
Lorazepam is also available as Lorazepam Intensol and Loreev XR. These medications include tablets, extended-release capsules, oral solutions, and injectable solutions. [3]
How and when to take lorazepam
Lorazepam should be taken exactly as prescribed. Oral tablets and oral liquid solutions may be swallowed with or without food and are typically prescribed to be taken two or three times a day. However, when taking lorazepam for insomnia, only one dose is prescribed, to be taken at bedtime.[4]
- Extended-release tablets allow the medication to be released into the body slowly, meaning that they only need to be taken once per day. They should be swallowed whole and not chewed or crushed.[3]
- Liquid lorazepam will be prescribed with a marked dropper, and the prescribing doctor will explain how to use it. The medication should be mixed with water or soft drinks before use and swallowed immediately.[3]
- Injectable lorazepam will be administered only by a trained professional and injected into the muscle or vein, depending on the circumstances.[2]
Standard Ativan dosage for different conditions
Ativan doses will vary depending on the condition treated. It is often used in the treatment of anxiety disorders and insomnia caused by anxiety. It is also used to treat status epilepticus, as a rapid tranquilization for agitation in inpatient services, as an anesthetic premedication, to reduce delirium or agitation during alcohol withdrawal, or to treat nausea associated with chemotherapy.[4]
Dosing for anxiety
The typical dosage for anxiety is 2-3 mg, which can be given two or three times per day. The maximum daily dose should be no higher than 10 mg.[1][4]
Side effects and precautions
Common side effects of Ativan can include: [1][3]
- Drowsiness
- Dizziness
- Nausea
- Diarrhea
- Weakness
- Unsteadiness
- Restlessness
- Blurred vision
These side effects typically go away on their own. If any side effects persist or worsen, contact the prescribing doctor, as you may require a change in dosage or medication. Also, if any of the following side effects occur, contact the prescribing physician immediately: [1][3]
- Difficulties with speech
- Rash or hives
- Trouble breathing
- Swelling of the mouth or face
- Extreme changes or irregularities in heart rate
- Tremor or shaking
- Shuffling walk
Precautions
Precautions to be aware of when commencing Ativan treatment include:[1]
- Pregnancy and breastfeeding: Taking Ativan while pregnant or breastfeeding may cause a risk of harm to the fetus or infant and should only be used if the benefits outweigh the risks.
- Impaired respiratory function: Ativan should be used with caution in people with lung or breathing conditions, such as sleep apnea or COPD.
- Elderly or physically impaired: Older adults and people with disabilities or other health conditions may require a reduced dose of Ativan.
- Liver or kidney impairments: Doses may need to be adjusted for people with liver or kidney issues, and close monitoring will be required throughout treatment.
- Interactions: Ativan can interact with other medications and substances, particularly other central nervous system (CNS) depressants. Before commencing Ativan treatment, inform the prescribing doctor of all medications and substances being used.
Navigating dose adjustments
Always take Ativan exactly as prescribed. If you feel that your current dosage is too low or too high, consult with the prescribing physician, who can advise on dosage adjustments.
Increasing the dose may temporarily cause new or worsening side effects. If these side effects persist, inform the doctor, as your dose may be too high.
Ativan overdose: What to do if you take too much Ativan
If you take too much Ativan, call 911 immediately and seek professional care. Ativan overdose can be dangerous and potentially fatal, particularly if it is taken alongside other CNS depressant substances such as alcohol or opioids.[1]
Symptoms of Ativan overdose can include:[1][3]
- Extreme drowsiness
- Confusion
- Lethargy
- Extreme changes in heart rate and blood pressure
- Difficulty breathing
- Slowed or stopped breathing
- Impaired heart functioning
- Loss of consciousness
Hospitalization, medical treatments, and professional monitoring may be required.
Long-term use, dependence, and withdrawal
The long-term use of Ativan is not recommended, as it can lead to dependence, addiction, and abuse. Because of these risks, lorazepam is a Schedule IV controlled substance. Ativan should not be used for longer than four months. If longer treatment is deemed medically necessary, regular reviews will be conducted to monitor the effectiveness and safety of the medication.[1]
Dependence can develop within weeks of using Ativan, which can cause withdrawal symptoms when the medication is stopped, particularly after prolonged use. Ativan withdrawal symptoms can include:[1]
- Anxiety
- Depression
- Insomnia
- Restlessness
- Sweating
- Dizziness
- Nausea and vomiting
- Hallucinations
- Seizures
- Shaking and tremors
- Changes in heart rate
- Memory impairments
Safe discontinuation: How to stop taking Ativan
When Ativan treatment is discontinued, it is recommended to gradually reduce the dosage. Abruptly stopping Ativan can increase the risk of withdrawal symptoms, which can be severe and sometimes life-threatening.
A tapering schedule may involve a dose reduction of 0.5 mg every three days to help prevent or reduce withdrawal symptoms. This can be slowed or stopped if necessary, if serious withdrawal symptoms occur. During the discontinuation process, the prescribing doctor will advise how to reduce the dosage and monitor for concerning effects. [4]
What to discuss with your healthcare provider
Before starting Ativan treatment, it is important to discuss with your healthcare provider the following:
- Any medications, substances, or supplements being used, as these may interact with the medication, impacting its effectiveness or increasing the risk of adverse effects.
- Any physical or mental health symptoms and conditions.
- If you are pregnant or planning to become pregnant.
- If you have a history of substance use issues or addiction.
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